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Must India model its healthcare system on the vastly inefficient and costly healthcare system of the West?

US Healthcare costs and expenditure | Credits and source details embedded in image.

he Euro-zone health system costs the tax-payer close to a trillion dollars (two-thirds of total healthcare expenditure paid by the State; total healthcare expenditure by EU is 10% of EU GDP, that is US$ 15 trillion). Ditto multiplied by two for the US. One trillion and two trillion for EU and US respectively.

The combined population of the US and EU is about the 800 million – versus the 1200 million of India. Even if due to lower costs, India were to replicate the EU and US systems, the expenditure will be US$3 trillion. That is 50% more than the Indian GDP.

Simplistic?

Sure. But, if we are going to throw around billions and trillions that belong to taxpayers, why worry?

These systems will collapse – and when that happens, there will be plagues and epidemics across the West.

Remember that less than a 100 years ago, the flu-epidemic killed tens of millions in the West. Conservative estimates start at 2 crores, go to realistic estimates of 4 crores (40 million) and some estimates go beyond 5 crores (50 million). This depletion in population, coupled with WWI deaths toppled the West into the Great Depression, ten years later.

As John M. Barry, author of “The Great Influenza,” has observed, “Influenza killed more people in a year than the Black Death of the Middle Ages killed in a century; it killed more people in 24 weeks than AIDS has killed in 24 years.”

The State as the natural and logical answer to every social problem is uniquely modern extension of Desert Bloc model of governance. The confidence that media and academia project in this model has no relation to reality.

We have seen the collapse of Spain, Portugal as imperial powers, Britain is at a tipping point – and many expect Pax Americana to follow.

Why must India duplicate this vastly inefficient and costly healthcare system of the West, as this recent article in the FT suggests.

Western governments could haul New Delhi to the WTO dispute panel to challenge its patent law as non-compliant with global trade rules, generics executives’ and health activists’ bigger worry is that the EU, and eventually the US, will secure provisions in new free-trade deals. These provisions would give western drugmakers more tools to stop Indian generic rivals.

Western pharmaceutical companies counter that India’s real health crisis is not the price of a handful of patented drugs but of a government that has abdicated its responsibility to ensure decent healthcare for its citizens. India’s government spends less than 1.2 per cent of gross domestic product on healthcare.

Some western companies, led by GlaxoSmithKline, are trying tiered pricing strategies in India to reflect the extremes of its wealth and poverty. Merck Sharp and Dohme sells its patented diabetes drug Januvia in India for about $24 per month, 80 per cent lower than its global price.

Still, the cut-rate price for Januvia has not deterred Glenmark, an Indian generics firm, from making its own version, which it sells for 30 per cent less than the discounted price. Last month MSD tried unsuccessfully to get a court order stopping Glenmark from selling its medicine, and protracted litigation lies ahead.

“You can parachute free medicine across the country but that will not improve access because you don’t the health infrastructure,” says Mr Shahani. “You don’t have doctors, you don’t have nurses, you don’t have nursing homes and you don’t have diagnostics.”

Shortages of nurses and orderlies meant young doctors had to do menial tasks such as carrying laboratory samples or wheeling patients into the operating theatre.

The junior doctors say the public hospital is so overstretched – and poorly managed – that they have to make snap decisions on how to handle patients, as if processing the wounded from a battlefield.

“This government doesn’t want patients to die, so our major concern is to prevent death, but what about proper management after that?” asks Sameer Prabhakar, a doctor at Safdarjung. “A doctor seeing 100 patients a day won’t have time.”

Safdarjung’s problems resonate across India’s public health system, which is starved of funds. Clinics struggle to cope with the flow of patients who can spend days queueing to see a doctor, only to be told they will have to wait months for treatment – even for potentially fatal diseases such as cancer.

India has just six doctors and nine hospital beds for every 10,000 people, compared with 15 doctors and 38 beds in China, and 24 doctors and 30 beds in the US, according to UN data. “The biggest question is: why is the government not building more hospitals and opening more medical colleges?” says Dr Prabhakar.

The emergence of swish upmarket private hospitals catering to India’s rich and middle classes is exacerbating the strain on public hospitals, as doctors, nurses and other specialists are drawn to the higher salaries and better working conditions.

With India spending just 1.2 per cent of gross domestic product on health – compared with nearly 3 per cent in China – the problems will not be resolved easily. Many poor Indians go to unqualified quacks. Lower middle-class patients are driven to private hospitals they cannot afford, clocking up debt to pay for essential treatment.

No mother is any lesser than any other. To try and show superiority …| Cartoon by Randy Bish, Pittsburgh Tribune-Review – May 10, 2013 via PoliticalCartoons.com

herever in the world it is, bringing up children is a job second to none.

Every mother and father, and societies that help them bring up a child deserve a lot of respect.

To see people scoring points likes this …

For Moms in Finland, every day is Mother’s Day. A new report from the non-profit Save the Children says that the Scandinavian nation is the best country on the globe for mothers to live.

Scandinavia is definitely a good place to be a Mom. Finland, which often places high on education and quality of life in other international lists, is followed by Sweden at no. 2 and Norway at no. 3. In fact, all but one of the top 10 countries where Moms are the safest are European, with Australia placing tenth.

The ten unsafest places for mothers are all located in Central Africa, with the Democratic Republic of Congo ranking worst. An estimated 98% of newborn and 99% of maternal deaths occur in developing countries where basic health care services are scarce.

Check out the top 10 best and worst countries for mothers below, and see the full report here.

Would all those in the fan club of Yummrika’s ‘systems’ like to take a look at the US medical system? .

Around 20% of US residents do not have access to the US medical facilities on fair terms. This has been a long running racket in the US medical industry – and the US Government has made some ham-handed attempts at solving this problem. | Cartoon titled The Raft Of The Uninsured- By RJ Matson, The St. Louis Post Dispatch – 11/21/2006 12:00:00 AM

he US Government recently passed laws ‘compelling’ hospitals to ‘reveal’ prices that they charge for uninsured individual customers – who are also not covered by employer medical insurance, or State Medicare, Medicaid system.

But even in this backward country, India, private medical costs are easily and commonly available. And for those who can afford, there is vast network of private medical care. For those who cannot afford, there is the State-assisted medical hospital system, which provides, few questions asked medical services to any comer.

Cartels and Monopolies

One can quibble, one can cavil, one can whine and moan, but is there anything worse than a country-wide cartel of hospital systems that will not reveal heir costs to the consumers, upfront, openly and freely.

And this is the system that India trying to copy – and promote.

No wonder we have this new phenomenon that private insurers promise cashless medical insurance – and after the patient is admitted, after costs are approved, at the time of discharge, the hospital presents a bill to the patients, of costs that not approved by the insurer.

The Government bill, running into a reported 2700 pages has been challenged in the Supreme Court. The current administrations point of view is that some solution is better than the rampant abusive cartelization that is presently the norm | Cartoon titled Obamacare Bike By Pat Bagley, Salt Lake Tribune – 3/27/2012 12:00:00 AM

Maya ahoy!

On with the story. American media is breathless with astonishment, when it took all the might of the world’s sole super-power, the US Government, to publish medical information on a Government website.

WASHINGTON — The actual cost of hospital care became a lot clearer for consumers on Wednesday when the Obama administration released the average prices charged by more than 3,000 U.S. hospitals for the 100 most common medical procedures.

The 2011 data, which shows wide cost variations at hospitals across the country – and in the same city or geographic area – raise questions about how treatment prices are determined and why the information has been so hard to get in the past.

Rates paid by private insurers and public health plans like Medicare and Medicaid are typically much lower.

The cost information is being released for the first time with the intent to “save consumers money by arming them with better information that can help them make better choices,” said Health and Human Services Secretary Kathleen Sebelius.

“When consumers can easily compare the prices of goods and services, producers have strong incentives to keep those prices low,” Sebelius said.

Inpatient charges to treat heart failure in Denver hospitals, for instance, ranged from a low of $21,000 to a high cost of $46,000, while the same procedure ranged from $9,000 to $51,000 at hospitals in Jackson, Miss. Inpatient costs related to joint replacement ranged from $5,300 at a hospital in Ada, Okla., up to a high of $223,000 at a hospital in Monterey Park, Calif.

That kind of price disparity puzzled Jon Blum, director of the federal Centers for Medicaid and Medicare Services. He said the cost variations could possibly reflect the health status of the patient, whether a hospital charges more because it trains future doctors, and even whether a hospital has higher capital costs that are passed on to patients.

But Blum added: “Those reasons don’t seem very apparent to us.”He said the charges “don’t seem to make sense to us from a consumer standpoint. There’s no relationship that we see to charges and the quality of care that’s being provided.”

Even though more than 40 states require or encourage hospitals to make their charges and payment rates public, the hospital association supports federal price transparency legislation sponsored by Rep. Michael Burgess, R-Texas.

Burgess’ proposal would require state Medicaid plans to ensure that states would pass laws requiring hospitals to make their charges readily available to the public and to provide information about patients’ estimated out-of-pocket costs.

And who are these uninsured, the uncovered. There is fairly narrow range that the total number of the uninsured and uncovered was between 48-52 million legal US citizens and 10-15 million US residents who have not be legalized. To this add the fact that this data pertains to years 2011-2012. Due the current economic climate this number probably is closer to 65 million US residents. That would be around 65 million US residents. In a population of some 330 million. 20% of the US population.

Not surprising that vested commercial interests who have been running an opaque medical system, are spending massive amounts of money in lobbying with their law-makers. This lobbing in USA, in India would be called bribes subvert a solution | Cartoon titled Obama Care By Arend Van Dam, source & courtesy – politicalcartoons.com on 3/26/2012 12:00:00 AM

And the Obama administration has passed a 2700-pages medical insurance law to cover these uninsured.

Three groups comprised the bulk of the uninsured in 2010, including foreign-born residents who are not U.S. citizens, young adults ages 19 to 25 and low-income families with an annual household income of less than $25,000.

The percentage of people who had health insurance through their employers fell to 55.3% in 2010 from 56.1% the year before, continuing a long, downward trend. In 2000, 64.1% of the population received health insurance through their employers.

The average health insurance premium for family coverage has more than doubled over the past decade to $13,770 a year, according to the Kaiser Family Foundation, a non-profit which focuses on health care policy and issues.

With fewer Americans receiving health care coverage through their employers, government-funded programs like Medicare, Medicaid, military health care, the Children’s Health Care Program (CHIPS) and coverage offered by various states have had to pick up the slack.

In 2010, 31% of Americans relied on the government for health insurance, up from 24.2% in 1999.

Many of the new government beneficiaries are children, according to Gould. Still, Census reported that 9.8% of children under age 18 are uninsured despite the government programs targeting them like CHIPS and Medicaid, which is also open to their parents.

Adults without dependent children, however, are not eligible for Medicaid in most states under federal rules, said Rachel Garfield, a senior researcher on the Kaiser Commission on Medicaid and the Uninsured. It’s this group that accounts for a large portion of the increase in the uninsured.

Nearly one-in-four working-age adults are uninsured, said Gould. She said it won’t be until 2014, when Obama’s Affordable Care Act fully kicks in, that more people will be able to find affordable health care coverage.

Kathleen Sebelius, the Secretary of Health and Human Services, said the report is evidence that the Obama administration’s health care reform is already starting to work.

Citing a provision that went into effect last year that allows parents to keep their children on their health insurance policy until they are 26 years old, Sebelius noted that the percentage of young adults ages 18 to 24 who were insured increased to 72.8% in 2010 from 70.7% in 2009.

There are widespread expectations that the US Supreme Court may uphold a legal challenge to the latest Government proposal, on a rather simple count of a complexity. | Cartoon titled Death and Politics By Parker, Florida Today – 2/2/2011 12:00:00 AM

After a year of bitter and partisan wrangling, the Obama administration passed a law that will enable coverage of these uninsured /uncovered.

If it survives Supreme Court scrutiny, the landmark overhaul will expand coverage to about 30 million uninsured people, according to government figures. But an estimated 26 million Americans will remain without coverage — a population that’s roughly the size of Texas and includes illegal immigrants and those who can’t afford to pay out-of-pocket for health insurance.

The US Government itself recognizes a figure that varies around 50 million. This excludes US residents who have been living in the US for several years – and there is an ongoing debate on how to legalize these residents.

Like this:

India has more children than the total population of any country in the world – except China.

How about doing a few things just coz they are right? Mebbe not ‘necessarily’ ‘profitable’ | Joel Pett, Lexington (Ky.) Herald-Leader, Cartoonists and Writers Syndicate, and was published on December 7, 2009 in USA TODAY

f people are becoming richer, more educated, in better living conditions, in a technologically superior time than any other in history, why can’t they afford children?

Earlier, when the father alone could raise a family of ten, today’s parents are afraid that, “even two incomes are no longer enough to make ends meet before pay day.”

You Pay For This …

The One Big reason that parents in the West and Japan are not having children is because of the cost.

The Other Big reason is, Western social and political leaders have made it uncool to have children.

Like this French woman-writer, Corinne Maier, who, disturbed at an exhibition of Belgian surrealists, decided, “at that point, I thought, ‘I really regret it, I regret having children.’ ” Her subsequent book, “40 Reasons for Not Having Children” in French, was also translated and sold well in English.

An American ‘comedian’ Adam Carolla was caught moralizing: “The best parenting of all is not shitting out the kids when you can’t afford the kids.”

This over-production, over-waste, over-war model can change. How about a 2ndlook? | Cartoon by Steve Greenberg on Oct. 22, 1994. in Seattle Post Intelligencer. For an updated cartoon – http://goo.gl/r9HLa

Am I Backward?

Why is the ‘developed’ world choose to commit a ‘demographic’ suicide.

By the way, here are the latest stats on the self-inflicted genocide of Japan.

As the nation celebrated the national Children’s Day holiday on May 5, the number of children under 15 years of age fell 150,000 from a year earlier to a record low 16.49 million as of April 1, according to government estimates released on May 4.

The child population shrank for the 32nd consecutive year and hit the lowest level since statistics became available in 1950, the internal affairs ministry said.

The estimates, based on national population census and other surveys, were compiled for Children’s Day on May 5.

Those under 15 years of age accounted for 12.9 percent of the total population, one of the lowest levels in the world. The corresponding figure is 19.6 percent in the United States, 16.5 percent in China and 15.6 percent in South Korea.

According to the estimates, there were 8.44 million boys and 8.04 million girls. By age, 3.55 million were between 12 and 14; 3.4 million were between 9 and 11; 3.2 million were between 6 and 8; 3.17 million were between 3 and 5; and 3.16 million were between 0 and 2.

Compelling logic, eh? First you impoverish people, then take away everything – and then blame them for all the problems! | Cartoon by Catherine Pain in a post titled Why are we surprised when we get what we pay for? on 24 April 2013; source & courtesy – open.ac.uk

By the way, the Indian children are nearly 31% of the gross population – and India has about 44 crore children.

India has more children than the total population of any country in the world – except China.

While American graffiti has become a cult symbol – a subject of books, films, media coverage, one graffiti by a Chinese tourist has become a national shame.

Will Chinese copy the US – and paint graffiti across the world? | Cartoon by Stephens on Wednesday, 29 May, 2013, 6:16am in South China Morning Post

uring and after WWII, American soldiers were parts of invading armies that warred in more than 50 countries. With the British and Russians, Americans were victorious in WWII.

Colonialism to Neo-Colonialism

After WWII, American armies waged long and expensive wars against Asians in South East Asia to impose US hegemony over former French, Dutch and British colonies.

Using a Communist bogeyman, propped by Eisenhower’s Domino Theory, American forces killed more than 50 lakh Asians (5 million) in Cambodia, Korea, Malaysia, Thailand, Vietnam. After the Asian Wars and the collapse of the Soviet Union, American attention has turned to the Islamic world.

Self Goal? More than international media, it were the Chinese who declared this graffiti as a ‘national’ shame. | Harry Harrison on May 27, 2013 in South China Morning Post

American Chopsuey

These American soldiers made their presence felt in countries they invaded and in those countries where American bases were set up – temporarily (like in India) or permanently (like in Japan).

American graffiti left behind at national monuments, historical sites – and on the bellies of pregnant women. Does the phallic overtones of this graffiti reveal the shallowness?

Graffiti itself goes back to ancient times. Graffiti is found in the ruins of Pompeii, on the walls of ancient Jerusalem, in ancient Egypt. Kilroy follows a long tradition, but was far more famous and all-present than any of them.

“Kilroy was here” emerged during World War II, appearing at truck stops, city restaurants, and in military boardrooms. However, the first appearances seem to have been on military docks and ships in late 1939.

“The mischievous face and the phrase became a national joke,” according to author Charles Panati. In theory, he was a soldier, probably American, who travelled all over the world scrawling his immortal phrase. Clearly, the graffiti were scrawled by thousands of different soldiers, not a single one named Kilroy.

During the Forties, Kilroy was everywhere. Panati comments, “The outrageousness of the graffit was not so much what it said, but where it turned up.” He cites the torch of the Statue of Liberty, the Arc de Triomphe in Paris, the Marco Polo Bridge in China, huts in Polynesia, and a girder on the George Washington Bridge in New York. There were contests in the Air Force to beat Kilroy to isolated and uninhabited places around the globe.

The appearance wasn’t always of GI origin, although it was largely tied to the military services. More than once newspapers reported on pregnant women wheeled into the delivery room, with the hospital staff finding “Kilroy was here” written across their stomachs. Panati says, “The most daring appearance occurred during the meeting of the Big Three in Potsdam, Germany, in July 1945. Truman, Attlee, and Stalin had exclusive use of an opulent marble bathroom, off limits to everyone else. On the second day of the summit, an excited Stalin emerged from the bathroom sputtering something in Russian to one of his aides. A translator overheard Stalin demand, ‘Who is Kilroy?'”

SDSTAFF Mac suggests Panati is a better storyteller than a scholar, though.

Low Self Image

China is whipping itself into a frenzy.

A graffiti by a Chinese teenager, discovered by another Chinese at the Egypt’s Luxor site, was taken up with a frenzy by ‘shamed’ Chinese. While American Graffiti has become a cult symbol – a subject of books, films, media coverage, one graffiti by a Chinese tourist has become a national shame.

Much like India scored a self-goal by making itself look like a country of rapists, when in fact, it has one of the lowest rape ratios in the world.

Does international media need anything more than these self-goals by the Chinese and Indians?

SHANGHAI—Parents of a Chinese junior high school student apologized on May 25 after their son’s name and graffiti were discovered defacing a wall of the ruins of the sacred Luxor Temple in Egypt, which ignited a storm of criticism on the Internet.

“My son understands that he did a bad thing,” his weeping mother was quoted by the Xian Dai Kuai Bao, a newspaper in Jiangsu province in coastal China, as saying.

“I am asking everyone to generously forgive my son (so that) this incident will not adversely affect his future,” his father was also quoted as saying.

The graffiti, written along with the student’s name in Chinese, reads, “I came here for sightseeing.”

Another Chinese tourist, who discovered the graffiti, wrote in Weibo, a Chinese version of Twitter, on the night of May 24, “I tried to erase this shame by rubbing it off, but my effort was in vain.” He also posted a photo of the graffiti.

Immediately after that, one poster after another criticized the graffiti on the Internet. One comment read, “I am ashamed of the graffiti as a Chinese.” Other posters also disclosed the student’s birthday and year of birth, and revealed that he is a junior high school student in Nanjing, Jiangsu province.

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